Amanda Wilde (Host): Welcome to the Health Headlines podcast series. In this episode, how Capital Health's Institute for Urban Care is building bridges to better health within the City of Trenton. I'm Amanda Wilde. Today I'm joined by Dr. Eric Schwartz, Executive Director for Capital Health Institute for Urban Care and RN Kim Watson. She is Director of Operations for Capital Health Institute for Urban Care. A warm welcome to you both. Thank you for being here.

Eric Schwartz, MD, MBA, FACP: Happy to be here.

Kim Watson, MSN, RN: Thank you, Amanda.

Host: Dr. Schwartz, starting with you. For those unfamiliar, could you explain the mission and purpose of the Capital Health Institute for Urban Care?

Eric Schwartz, MD, MBA, FACP: Yeah, the Institute for Urban Care is really here to help support Capital Health in it's mission to care for the Trenton community. We're built around the needs and assets of the Trenton community. Predominantly, our major foci are addressing chronic disease, maternal child health and behavioral health, substance use disorder, all on a foundation of community.

So we've built programs, collaborative programs with members of the community, community-based organizations to really help improve the health and wellbeing of the Trentonian community.

Host: Can you tell us a little bit about your role in that configuration as executive director?

Eric Schwartz, MD, MBA, FACP: Sure. As executive director, so, I had the opportunity to really start the Institute for Urban Care back in 2017. Our CEO Al Maghazehe has such a commitment for the city of Trenton that, he asked me to come back to Trenton. I had been part of the Trenton community. I was a chief medical officer of our federally qualified health center for about 10 years.

And, left and was working for another health system and he asked me to come back to really lean in so that we can really support and improve the health and wellbeing of the Trenton community. And from that, the Institute for Urban Care was born and really had the opportunity to work with the most incredible people, as part of our department, as well as so many people from the Trenton community.

Host: As the Director of Capital Health Institute for Urban Care, what are some of the most common challenges you've seen that Trenton residents face as it relates to healthcare?

Eric Schwartz, MD, MBA, FACP: Well, yeah, so I'm also, working as a primary care physician, so I get that real life experience of what people's challenges are. When you're talking to somebody, about their diabetes, or their high blood pressure and then as part of the conversation you find out that they don't have enough food to eat, or they don't have a safe place to live.

It kind of gets you to take a step back and say, how can we put in systems of care support so that we can address those social drivers of health so, people can be comfortable and have the right food to eat so that we can then address their medical issues. So a lot of our programming is really built on that, the supportive care that we need, outside of medical care, but what people need in order to really optimize their wellbeing, and their health.

Host: So keeping that in mind, what are the areas of strategic focus for the IUC and how are they determined? You said partially by the clients themselves.

Eric Schwartz, MD, MBA, FACP: Yeah. And, again, what the needs are in the community. So a good example is chronic disease. As a primary care physician, when I talk about chronic disease, I'm talking about things like diabetes, high blood pressure, and unfortunately in our community violence, we consider, really a health crisis, in our community.

So we have programs such as our victory program. Which provides wraparound services for anybody who is a victim of violence in our community. We have a team that meets with them, connects them to behavioral health services, relocation services, helping them get a job, and the like with a goal of really preventing re-injury, retaliation, and the incidence of post-traumatic stress disorder.

Capital Health is a level two trauma center, so again, we unfortunately see a fair amount of trauma victims and this service is just really that ability to, kind of embrace that patient and support them. So we're dealing with not only their medical needs, but really their social needs. This program is approaching 500 patients, really 500 families, I guess, that they have helped.

So that's just one example of our programs and how we can really support our community.

Host: Kim, I want to bring you in here to add to what Dr. Schwartz is saying. As Director of Operations, are there specific programs or initiatives that the IUC is involved in that you'd like people to be aware of?

Kim Watson, MSN, RN: Sure. The For My Baby and Me program, which is an opioid addiction targeted program for pregnant moms and newly delivered moms in the area. And that program provides wraparound services through community partnerships, which is kind of what we lean into. We couldn't do this work without our community partners in the city of Trenton.

And, I'm happy to report that we've had almost 200 mothers, go through our program and get services for addiction that wasn't offered to them in the community that they just couldn't find or engage with or felt comfortable. And it's, uh, secondary community almost. They're joined and supported by moms who've gone through this.

We have a program ambassador who was a program participant who now leads the charge in engaging women and getting them into treatment. We have also, Dr. Schwartz had mentioned briefly about, our Cardiac Opportunities for resilience, our core program, which is helping disadvantaged Trenton residents in managing their cardiac care.

We also have involvement in the Trenton Neighborhood Initiative, which is a legacy project from our CEO that really just wants to uplift, the internal and external community here at Capital Health. We also have a partnership with Arm in Arm, where we've engaged in a mobile food pantry.

So instead of just sending our residents to established food pantries, we bring the food to them at two separate locations four times a month. That has been extremely, valuable, because the city of Trenton's consider a food desert. And then from that we also have a partnership with the Trenton Area Soup Kitchen, where they bring hot meals directly to our clients in the community.

Host: Those are some wide reaching collaborations that you have going. Are there other community partners that IUC works with that we should know about?

Kim Watson, MSN, RN: Yes. The Trenton Health team, they're partnered with us in multiple programs, Catholic Charities of Trenton, the Rescue Mission, Home Front, Aisles, Salvation and Social Justice. The Trenton Restorative Street team, Trenton Community Street team, the list could go on and on, but again, we couldn't do this work without being able to lean into those partners.

Host: And what impact have you seen the IUC's work have on the Trenton community? Kim, I'll start with you, but I'd like to hear Dr. Schwartz on this one as well.

Kim Watson, MSN, RN: So just touching on our violence intervention program. We started that program in 2019. It's a hospital-based violence intervention program, but within a few years, they saw that there was a community need as well, and there are now two community street teams for violence intervention and we work collaboratively with them.

And we've seen a drastic reduction in gun violence in the city of Trenton since those street teams and our hospital based program has been initiated.

Host: So really some big results. Dr. Schwartz, what impact have you seen the IUC's work have on the Trenton community?

Eric Schwartz, MD, MBA, FACP: So, just to add to what Kim was talking about, you know, the secret sauce for the Institute for Urban Care is really our ability to collaborate. So, you know, we've had a lot of success in impacting the community. But a lot of that success is through that collaboration, with the community.

One of our programs that comes to mind is our Trenton neighborhood initiative. This program is really looking at impacting the way Trentonians live, work, grow, and connect. Each of those pillars have multiple programs. So for example, our lift pillar, we have a down payment assistance program. Anybody who has a first-time home buyer in the city of Trenton, we provide, working again with partners, the ability to get financial counseling because buying a home can be very complicated. And, if somebody is deemed ready to buy a home, we can give them up to $20,000 in down payment assistance. This program's been up running for about three years or so and to date, 53 families have bought their first home in the city of Trenton.

Average price a home in Trenton is about $225,000. So through this program alone, we've catalyzed about $11 million in equity in our community. We have people that are now paying their mortgage and building equity as opposed to paying rent. So that's one example within our Trenton neighborhood initiative.

We work with a partners Mercer County Community College. We've given away or supported, more than 160 scholarships. As a matter of fact, last week we had some of our TNS scholars from Mercer County Community College through Capital Health. They come, they take a tour. When they're done with their training, they get an interview and it's more than just scholarships. It's a pathway to jobs. What we're really trying to do is help build generational wealth in our community.

Host: Yeah, I was going to say these programs you've built really have such a wide scope, they touch on social services. Why do you feel it's important for hospitals to have a department like this, which is directly involved in improving the wellbeing of the surrounding community?

Eric Schwartz, MD, MBA, FACP: Well there are actually many studies. One comes to mind, looks at what contributes to, longevity or you know, premature death. And, only 20% of that is really based on healthcare. The other 80% is based on people's individual behaviors and the community and resources that they have.

Do they have a safe place to live? Do they have money to buy food, for shelter, social connection, safety, and the like? So, the majority of people's wellbeing is really based on the social drivers of health. And Capital Health having that really, perspective of caring for our community for really more than a century; we recognize that we have to do more than just providing outstanding care, which we certainly do. We've got some of the finest physicians and medical programs really in the state. But we realized that we needed to do more to really support our community, as an anchor institution.

So we've built these programs to really address those social drivers of health, and we're starting to see really improved outcomes.

Host: A very holistic approach. And with that in mind, Kim, how do you think your career and experience as a nurse has impacted your role within the Institute for Urban Care, which obviously has a very broad base.

Kim Watson, MSN, RN: So, I was fortunate enough to work in the trauma ICU for most of my career, so, a lot of our patient's were critical. There was opportunities to provide support to families, support to our coworkers. We did some, you know, really heavy, heavy work. So with that in mind, really just getting to know our community, being kind of ingrained in that, I trust Capital Health for all of my care, for my family, all four of my sons were born here. And I would choose Capital over any other institution just based on the level of care that you provide. The patient in the bed, regardless of how they ended up there, is treated equally. And that pretty much comes across, I think, in our care.

How I like to describe our department here too, is our programming picks up when those hospital doors close. So we can't stop our care when the acute problem is addressed. This is for those chronic issues. That's what the institute is strong, and is able to provide services for, is that support once they've return the community and giving them options and additional resources.

Eric Schwartz, MD, MBA, FACP: I was just going to add, you know, kind of watching Kim with the nursing students, last week from Mercer County Community College, you saw her desire to actually, uh, really enjoy engaging and educating young nurses that are earlier in their career. And the other element is, bringing additional services. For example, Kim and team working at our mobile food pantry provided a flu clinic. Many patients that come to the mobile food pantry might not have the kind of clinical care that they needed. Kim, really recognizing that, you know, when ounce prevention is worth a pound of cure, was there with other students, with other nurses, giving flu shots to the community. So really having a tangible impact on the health of the community.

Host: So the institute provides information, resources, professionally passes down knowledge to up and coming folks in the medical community, and you bring in additional services. You are all in on your community. Dr. Schwartz, where can people go for more information about the IUC and potentially get involved in some of the great work that IUC is doing in the community?

Eric Schwartz, MD, MBA, FACP: Well, yeah, certainly they can, check out our website at CapitalHealth.org. We have a specific Institute for Urban Care, IUC as we like to call it. You know, a website. A, a great example of where people can come and volunteer is our mobile food pantry. As Kim mentioned, pretty much every Wednesday, we are at one of our sites somewhere in Trenton, either working, with the city at one of the area parks or outside, some of our practices giving out food, working with Arm in Arm, working with Trenton Area Soup Kitchen. We could always use volunteers to connect. We have people that volunteer coats. We have a coat drive during the winter. So, many ways that people can really volunteer and work with us as we improve the health and wellbeing of our community.

Host: Dr. Eric Schwartz, RN Kim Watson, thank you for this inside look at Capital Health's Institute for Urban Care, for being responsive to improving the quality of life in your community and rising to the needs of your local community.

Eric Schwartz, MD, MBA, FACP: Thank you for having us.

Kim Watson, MSN, RN: Yes. Thank you, Amanda.

Host: Dr. Eric Schwartz is Executive Director and RN Kim Watson is Director of Operations at Capital Health Institute for Urban Care. To learn more, visit Capitalhealth.org/urbancare. And if you found this podcast helpful, check out our entire podcast library for topics of interest to you. Thanks for listening to Healthy Headlines podcast series from Capital Health.